Bills would expand VA telehealth services across state lines

WASHINGTON — Telehealth services for veterans have expanded dramatically in recent years, but a group of lawmakers worries that federal rules governing that remote care haven't kept up.

On Tuesday, a bipartisan group of House members and senators reintroduced legislation designed to boost access for veterans by easing those rules, arguing that patients in rural areas or facing travel difficulties are being disadvantaged by outdated regulations.

"This is allowing our veterans to access VA health care across state lines," said Sen. Joni Ernst, R-Iowa, and a National Guard veteran. "That is so important, because there may be a specialist (somewhere) right now that they don't have access to.

"This would allow those veterans, in the comfort of their own home, to be able to consult with a physician, over the phone or the internet."

The legislation amid a years-long push from the Department of Veterans Affairs to expand medical access and appointments to a growing list of patients, and amid continued criticism that the bureaucracy can't keep up with demand.

In 2015, the VA conducted 2.14 million telehealth visits, reaching more than 677,000 veterans. But supporters of the efforts say even more patients could benefit.

Under current law, VA doctors can provide treatment via the phone or internet chat services for a host of routine appointments, including some mental health services.

But the rules bar physicians from providing those services across state lines, unless both the veteran and the doctor are located in federal facilities. That limits the telehealth options for individuals in remote areas, like Alaska and Hawaii, and still forces many veterans to travel significant distances to get to an approved facility.

The bills introduced in the House and Senate would change that, allowing veterans to receive remote care anywhere, including a home or nearby community center.

"The VA has seen tremendous growth and interest in telehealth," said Rep. Julia Brownley, D-Calif., a bill sponsor and member of the House Veterans’ Affairs Committee. "And we should continue to find new ways to connect veterans with the providers that they need, no matter their physical location."

Brownley is co-sponsoring the House legislation with Rep. Glenn Thompson, R-Pa., whose son serves in the Army. Ernst’s mirror legislation in the Senate is co-sponsored with Sen. Mazie Hirono, D-Hawaii, who serves on the Senate Veterans’ Affairs Committee.

The group is hopeful the bipartisan, bicameral push will advance the legislation this session. Last year, similar efforts stalled in Congress. Ernst called it a common sense measure.

"Many of (my colleagues) don’t know you can’t do home telehealth over state lines, and are asking, ‘Well, why not?’" she said. "And I’m saying, ‘exactly, that’s why we’re doing this bill.’"

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The bills would change some monitoring and oversight rules regarding VA telehealth program, requiring VA to provide more information on the effectiveness of current offerings. No hearings have yet been scheduled for the measures.

Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at lshane@militarytimes.com.